Day Two - CT (Central Time)
Join CMS and other industry leaders as they share their vision for navigating today's complex landscape and important updates heading into 2026 and beyond.
- Kristie Gurley - Partner, Washington, Covington & Burling LLP
- Rujul Desai - Deputy General Counsel, Chief Legal Officer for CMS, U.S. Department of Health & Human Services
- Josh O'Harra - Deputy General Counsel, Eli Lilly and Company
- IRA impacts on 340B pricing and identify optimization strategies
- Assess MFP reforms' effect on 340B participation requirements
- Develop compliance approaches across overlapping policies for financial sustainability
- Analyze how PBM formulary decisions may be impacted by MFP implementation, including potential disincentives to include negotiated products and strategies for ensuring continued patient access
- Katheryne Richardson, PharmD - Managing Director, Berkeley Research Group, LLC
Hear from an expert panel of attorneys as they each moderate a topic and interactive discussion among attendees, and themselves, on the most pressing issues facing MDRP and Government Pricing.
- Jesse Mendelsohn - Senior Vice President, Model N
- Jeffrey Handwerker - Partner, Arnold & Porter LLP
- John Shakow - Partner, King & Spalding LLP
- Kristie Gurley - Partner, Washington, Covington & Burling LLP
- Meena Datta - Partner, Sidley Austin LLP
- Analyze recent judicial decisions affecting contract pharmacy models and stakeholder responses, including implementation approaches for manufacturer rebate systems as alternative distribution strategies and their operational challenges
- Assess emerging state legislative measures designed to affect 340B program implementation, examining jurisdictional considerations and avenues for navigating overlapping federal and state requirements
- Examine strategic considerations at the intersection of 340B compliance and IRA implementation, focusing on methodologies for managing discount integrity across programs and adapting to evolving guidance on patient definition parameters
- Jennifer Plitsch - Partner, Covington & Burling
- Patrick Greene, PharmD - Director, Strategic Pricing & Contracting, Veloxis Pharmaceuticals
- Identify how 340B program dynamics influence cross-functional operations, including field sales, product lifecycle planning, distribution strategy, and financial forecasting considerations
- Showcase center of excellence structures that optimize program management across legal, finance, market access, and government pricing functions, with case studies on team composition and collaboration
- Construct frameworks for communicating 340B implications to C-suite executives, including business impact quantification, risk assessment methodologies, and integration with broader pricing strategies
- Differentiate organizational models for 340B management, from siloed approaches to integrated centers of excellence, with insights on team structure, reporting relationships, and resource allocation
- Map data governance frameworks supporting both 340B program integrity and IRA requirements, including strategies for historical data retention relevant to Medicare negotiations
- Samantha Gross - Corporate Counsel, Pfizer Inc
- Matthew Fornataro - Partner, Arnold & Porter
- Evaluate the administration's approach to pharmaceutical imports, including tariff policies affecting products from China, India, and the EU, and their impact on cost structures and supply decisions
- Interpret "Made in America" requirements for Federal Supply Schedule (FSS) products and their implications for manufacturing, sourcing strategies, and government contracting
- Investigate the intersection of tariff policies with supply chain pressures, including shortage mitigation efforts, onshoring incentives, and manufacturing quality requirements
- Formulate effective approaches for navigating cross-border product movements, including customs classifications, country-of-origin determinations, and documentation requirements
- Allison Pugsley - Partner, Hogan Lovells US LLP
Pharmaceutical manufacturers and third-parties (e.g., GoodRx) are increasingly adopting consumer-directed health care initiatives. These initiatives, which focus on giving patients enhanced choices and access to health care, may offer consumers “one stop” access to prescription drugs through cash-pay discount drug programs (that operate outside of insurance), telehealth prescribing, and/or online pharmacies. The market for these types of offerings is rapidly developing, presenting alternative channels to commercialize drugs, with a wide range of related legal considerations. This session will:
- Identify trends in consumer-directed health care initiatives, taking a detailed look at common structures
- Provide an overview of potential legal considerations and concerns
- Examine recent government scrutiny and enforcement actions
- Highlight key “watch outs” in implementing initiatives and options to mitigate risk
- Margaux Hall - Partner, Ropes & Gray LLP
- Alison Fethke - Counsel, Ropes & Gray LLP
- Eve Brunts - Partner, Ropes & Gray
- Outline essential MFP requirements and implementation status, including practical approaches for meeting program guidelines and strategic considerations for compliance across different company sizes
- Navigate treasury operation changes from traditional 45-day cycles to daily payment requirements, establishing cross-system integration between government pricing platforms and financial systems
- Guide manufacturers through September deadline preparations, covering documentation requirements, operational readiness assessments, and compliance verification processes
- Develop robust data governance frameworks for maintaining historical pricing information required for Medicare negotiations, including strategies for source documentation preservation and audit preparation
- Josh O'Harra - Deputy General Counsel, Eli Lilly and Company
- Justin Linder - Managing Director, Consulting, Riparian
- Jacqueline Roche - Head Payment and Delivery and Global Policy Institute, J&J
- Understand the specific considerations for physician-administered drugs entering Medicare negotiation in Round 3, including ASP reporting requirements and distinct operational challenges
- Assess the potential marketplace impacts of MFP on Part B drug reimbursement, formulary positioning, and future investment decisions for injectable and infused therapies
- Explore strategies for communicating with providers and health systems about Part B drug pricing changes and their potential effects on acquisition costs and administration fees
- Examine policy considerations and potential regulatory changes that may affect Part B drug pricing and reimbursement as IRA implementation evolves
- Natalie Morris - Director, Public Policy & Reimbursement, Takeda
- Kathleen Peterson - Counsel, Hogan Lovells US LLP
- Samantha Marshall - Counsel, Hogan Lovells
- Compliance challenges, data management burdens, and resource constraints that impact hospital 340B programs daily
- First-hand accounts of how program disruptions directly affect vulnerable community members and hospital services
- The unseen administrative maze hospitals navigate to maintain care continuity amid policy shifts
- Hospital executives share practical pathways for manufacturer partnerships that acknowledge covered entity constraints
- Explore structured engagement models including advisory councils, voice-of-customer sessions, and formal feedback mechanisms that maintain compliant relationships while gathering actionable insights
- Thomasyna Sweed - 340B Program Manager, LifeSpring Health Systems
- Tess Morgan - Senior Manager, Product Diversion and Program Integrity, Pfizer
- Understanding differing risk profiles for different product archetypes
- Considerations to keep in mind prior to product launch
- Divergent tactics for different points in the product channel
- Maintaining positive relations with covered entities and vulnerable patient populations
- Michael Kurland - Vice President, Revenue Management & Compliance Solutions, EVERSANA
- Megan Seyboth - Associate Director, EVERSANA
Examine financial challenges and business decisions for products facing underwater pricing in Medicaid
Explore portfolio management approaches and market repositioning strategies from established manufacturers
Evaluate cross-functional frameworks for addressing negative margin products, including legal and market access considerations
Develop actionable insights for mature brands in an increasingly complex rebate environment
- Rafael Angulo - Head, Revenue Finance, Sandoz
- Navigate evolving state transparency requirements while effectively safeguarding sensitive pricing information through proven trade secret protection strategies
- Understand current enforcement priorities and respond strategically to state inquiries based on recent case studies from Oregon, New York, and Colorado
- Develop cross-functional protocols to streamline reporting processes while maintaining consistency across multiple state submissions
- Implement practical approaches to engage constructively with state regulators while advocating for reasonable interpretations of disclosure requirements
- Judd Caulfield - Senior Counsel, Takeda Pharmaceuticals
- Sara Simon, JD - Counsel, Porzio, Bromberg and Newman
- Sharon Small - Director, Counsel Market Access, Government Pricing & Policy, Novartis Pharmaceuticals Corporation
- Review practical experiences from the first invoicing cycles for inflation rebates, including calculation methodologies, dispute resolution processes, and system integration challenges
- Develop effective approaches for evaluating inflation rebate invoices and managing the compressed timeframe for appeals and adjustments
- Inspect the complex interplay between price increase decisions, inflation rebates, and other pricing considerations in today's regulatory environment
- Explore innovative strategies for maintaining product lifecycle value while navigating the constraints of inflation penalties across Medicare and commercial markets
- Establish cross-functional workflows connecting government pricing, finance, and treasury functions to manage the evolving payment requirements across inflation rebates and MFP implementation
- Design system integration approaches that ensure accurate calculation, timely payment, and proper financial reporting in the new regulatory landscape
- Roneil Narciso - Director - Strategic Pricing & Contracting, AVEO Oncology
- Dalton Wilkins - Associate Director - Government Pricing & Reporting, PharmaEssentia USA Corp
- Melody Hamel - Senior Operations Counsel, Viatris Inc
- Analyze early market signals regarding PBM and health plan treatment of MFP-negotiated products, including formulary positioning, prior authorization requirements, and utilization management strategies
- Develop commercial strategies that address the changing rebate dynamics for products subject to MFP, including approaches to maintaining competitive formulary positioning
- Understand the implications of IRA implementation on biosimilar and generic competition, including potential shifts in market entry timing and pricing strategies
- Explore the evolving landscape of patient affordability programs for products subject to MFP, including benefit design optimization and alternative access models
- Rosalind Davis - Director, Government Pricing and Contracts, CSL Vifor Pharma
- Jennifer English - Chief of Staff for Value & Access, Head of Strategic Pricing, Marketing & Analytical Operations - V&A Strategy Hub, Ipsen